Kornimate/medical-research-clean huggingface dataset:
fractional excretion of urea for the differential diagnosis of acute kidney injury in liver cirrhosis

Conditions: Liver Cirrhosis

Summary: the aim of this study is to evaluate the diagnostic performance of feurea for the differential diagnosis of aki in patients with cirrhosis and ascites specifically, the ability of feurea to distinguish between atn versus pre renal azotemia and hrs.

aki according to kdigo guidelines is defined as the followings: * an increase in serum creatinine by ≥0.3 mg/dl (≥26.5 µmol/l) within 48 h * an increase in serum creatinine to ≥1.5 times baseline within the previous 7 days * urine volume ≤0.5 ml/kg/h for 6 h serum creatinine overestimates renal function in cirrhotic patients due to a number of factors: creatinine production in patients with cirrhosis is reduced due to muscle wasting, there is an increased secretion of creatinine in the renal tubules, scr may be diluted due to an increased volume of distribution, and finally, high bilirubin levels may interfere with the assays to measure its level. recently, the international club of ascites (ica) has adopted the concept of aki which was developed originally to be used in general critically-ill patients. aki is defined as the increase of at least 0.3 mg/dl (26 μmol/l) and/or ≥ 50% from baseline, within 48 hours since urea absorption is largely modulated in the proximal tubules, it is not affected by diuretics acting more distally. the investigators therefore hypothesized that the fractional excretion of urea (feurea) could serve as a clinical aid in making an early distinction between atn versus pre renal azotemia and hrs type 1 in patients with cirrhosis and ascites presenting with aki fractional excretion of urea (feurea) (\[urine urea nitrogen/ blood urea nitrogen)/(urine creatinine/plasma creatinine)\] x 100) \ 50% is specific for atn

Eligibility criteria:
inclusion criteria: * liver cirrhosis of any etiology diagnosed by clinical parameters involving laboratory tests, endoscopic or radiologic evidence of cirrhosis, * history of decompensation (hepatic encephalopathy, ascites, variceal bleeding, jaundice) * age greater than 18 years * presence of moderate or severe ascites exclusion criteria: patients excluded from analysis were those who did not meet inclusion criteria as well as the following * prior liver or kidney transplant, * advanced chronic kidney disease g4(gfr category grade 4) according to kdigo guidelines. * patients on acute or chronic renal replacement therapy, * ambiguous diagnosis of aki and phenotype of aki, * patients with hepatocellular carcinoma.
vexus-guided fluid management in patients with acute kidney injury in the intensive care unit

Conditions: Acute Kidney Injury; Renal Insufficiency, Acute; Kidney; Disease, Acute; Critical Illness; Volume Overload; Fluid Overload

Summary: a quasi experimental study that aims to verify whether the incorporation of vexus in patients with aki in the intensive care unit (icu) may prompt tailored interventions to increases the number of days free from renal replacement therapy (rrt) during the first 28 days.

fluid overload is associated with organ dysfunction, such as acute kidney injury (aki), and increased mortality. it remains unclear if fluid overload is merely an epiphenomenon in critically ill patients or if organ congestion is a mediator of complications. considering aki related to fluid overload, diuretic therapy would reduce venous congestion and improve renal blood flow. the venous excess ultrasound score (vexus) identifies clinically significant venous congestion and indicates a high risk of post-operative aki. this quasi-experimental study aims to verify whether the incorporation of vexus in patients with aki in the intensive care unit (icu) may prompt tailored interventions to increases the number of days free from renal replacement therapy (rrt) during the first 28 days.

Eligibility criteria:
inclusion criteria: * non-elective icu admission * severe acute kidney injury (aki) defined either: a ≥ 2-fold increase in serum creatinine from a known pre-morbid baseline or during the current hospitalization or urine output \< 6.0 ml/kg over the preceding 12 hours exclusion criteria: * life-threatening indication of rrt (defined as intractable hyperkalaemia, acidosis, uraemic symptoms) at day 0 * rrt before recruitment * use of extracorporeal membrane oxygenation (ecmo) * hepatic cirrhosis or other condition with portal hypertension * lack of commitment to provide rrt as part of limitation of ongoing life support * known pre-hospitalization advanced chronic kidney disease, defined by an estimated glomerular filtration rate \< 30 ml/min/1.73 m2 or chronic rrt * refusal to sign the informed consent form
a controlled clinical study to determine the gingivitis benefit of flossing

Conditions: Gingivitis

Summary: this is a randomized, controlled, examiner-blind, parallel group, four week clinical study comparing brushing plus flossing to brushing alone in healthy adults with mild-to-moderate gingivitis.


Eligibility criteria:
inclusion criteria: * at least 18 years of age; * physically able to floss his/her teeth; * refrained from performing oral hygiene the morning of the baseline visit; * have measurable gingivitis on at least 5 test sites; * in good general health. exclusion criteria: * severe periodontal disease * atypical discoloration or pigmentation in the gingival tissue; * meaningful malocclusion of the anterior teeth; * fixed facial orthodontic appliances; * use of antibiotics within two weeks of the baseline visit and at any time during the study; * any diseases or conditions that could be expected to interfere with the subject safely completing the study.
dysfunctional hemoglobin pulse oximetry

Conditions: Carbon Monoxide Poisoning

Summary: the purpose of the study is to assess device performance in the presence of carbon monoxide.


Eligibility criteria:
inclusion criteria: * the subject is male or female. * the subject is of any racial or ethnic group. * the subject is between 18 years and 50 years of age (self-reported). * the subject does not have significant medical problems (self-reported). * the subject is willing to provide written informed consent and is willing and able to comply with study procedures. * exclusion criteria: * has a bmi greater than 30.0 (calculated from self-reported weight and height). * has had any relevant injury at the sensor location site (self-reported). * has a deformity or abnormalities that may prevent proper application of the device under test (based on visual inspection). * has a known respiratory condition (self-reported). * is currently a smoker (self-reported). * has a known heart or cardiovascular condition (self-reported). * is currently pregnant (positive serum pregnancy test at screening visit or positive urine poc test on day of study). * is female and actively trying to get pregnant (self-reported). * has a clotting disorder (self-reported). * has raynaud's disease (self-reported). * is known to have anemia (hemoglobin value below lower range of normal for gender) * is known to have a hemoglobinopathy such as sickle-cell anemia or thalassemia (abnormal hemoglobin electrophoresis). * is known to have a inherited or congenital methemoglobinemia (self-reported). * has unacceptable collateral circulation from the ulnar artery (based on exam). * is unwilling or unable to provide written informed consent to participate in the study. * has another health condition which in the opinion of the principal investigator makes him/her unsuitable for testing.
levetiracetam administration for the management of levodopa-induced dyskinesias in parkinson's disease

Conditions: Levodopa Induced Dyskinesia

Summary: levodopa-induced dyskinesias have been associated with irregular oscillatory discharge characteristics of basal ganglia. from the other hand, lev which shares a different electrophysiologic profile than other antiepileptics, inhibits hyper-synchronization of abnormal neuronal firing in experimental models of epilepsy. lev also reduces levodopa-induced dyskinesias in mptp-lesioned macaques and modulates "priming phenomenon" which associated with long-term changes in synaptic function that can lead to dyskinesias in pd. study objectives : * to evaluate the effects of levetiracetam (lev) in two doses (500 and 1000mg) vs placebo on disabling dyskinesias that develop as result of long-term treatment with levodopa, occurring at the time of maximal clinical improvement in patients with parkinson's disease (pd). * to evaluate the safety of lev in patients with pd and antiparkinsonian medication.


Eligibility criteria:
inclusion criteria: diagnosis of pd will be according to the criteria of united kingdom parkinson's disease society brain bank. other inclusion criteria: * patients between ages 30 and 80 * hoehn and yahr stage of pd over iib * levodopa-induced dyskinesias (lid) despite optimization of antiparkinsonian medication * lid severity 2 on item 32 and duration 2 on item 33 of the unified parkinson's disease rating scale (updrs) part iv * patient is willing to adhere to protocol requirements as evidence by written informed consent exclusion criteria: * patient has a history of any medical condition or clinically significant laboratory abnormalities that can subject them to unwarranted risk. * female patient is pregnant or breastfeeding or has not been using or was not continuing to use an adequate contraceptive method for the last 30 days, or is not at least one year post-menopausal. * patient with ablative surgeries or dbs implantation electrodes for diseases of the basal ganglia. * patient has a low mini-mental examination mmse score \<25 or has a history of bipolar psychosis or schizophrenia. * patient is unwilling to sign an informed consent or to comply with protocol requirements. * patient is taking or has taken in the past month amantadine.

Keywords: levetiracetam levodopa-induced dyskinesias parkinson's
reducing length of stay in the emergency department

Conditions: Length of Stay

Summary: emergency department (ed) crowding has become an international challenge in the recent decades. length of stay (los) is a useful marker to monitor ed crowding. searching for the possible causes and reducing barriers may have the greatest impact on edlos. therefore, the investigators assembled a multidisciplinary team for improvement of the ed process, to undergo assessments of ed patient flow with the spirit of lean-sigma methodologies. the objectives of this study were to evaluate a lean-sigma-based initiative to lessen edlos.

lean aims to smooth out the workflow and to eliminate wastes. in the ed settings, lean principles can display the process of the ed patient flow. six sigma, a complementary strategy, has the merit to compensate the potential weakness of lean through a data-driven process. currently, a combination of lean and six sigma methodologies develops to solve the problems of workflow. it became clear that concurrent multifaceted interventions were needed to reduce edlos. therefore, the investigators assembled a multidisciplinary quality improvement team for improvement of the ed process, to undergo assessments of ed patient flow with the spirit of lean-sigma methodologies. the objectives of this study were to evaluate a lean-sigma-based initiative to lessen edlos.

Eligibility criteria:
inclusion criteria: * the patients were registered in the ed from jan, 2015 to dec, 2015. exclusion criteria: * the patients were excluded because of left without seeing a physician.
use of tocilizumab for rheumatoid arthritis (ra) in daily routine

Conditions: Rheumatoid Arthritis

Summary: this prospective, multicenter, non-interventional study will enroll participants from routine clinical practice in germany who are receiving tocilizumab for ra. the objective of the study is systematic collection of data on use of tocilizumab in daily routine with special emphasis on treatment decision by the prescriber, compliance with summary of product characteristics (smpc), and documentation of relevant activity scores and adverse drug reactions (adrs). the maximum observation period will be 12 months per participant.


Eligibility criteria:
inclusion criteria: * moderate to severe ra * tocilizumab indicated in accordance with smpc and chosen by the treating physician in advance of the study exclusion criteria: * none specified
integrated rehabilitation program for fractures

Conditions: Humeral Neck Fracture; Vertebral Fracture; Distal Radial Fracture; Hip Fractures

Summary: the recovery of range of motion and muscle power after surgical intervention of the fracture will mostly affect patient's daily activities. so postoperative rehabilitation program will play the important role. correct and effective physical therapy will reduce the functional impairment of limbs after long term casting or surgical fixation, and accelerate to recover the independent daily activities. there is no consensus between immediate or delay and the duration of continue physical therapy will improve the shoulder function、muscle power and degree of satisfaction( physiological function、social function、mental health、 pain、 general health status ) after surgical fixation of fractures. this study will evaluate the patients of the fracture that including of the humeral neck fracture, vertebral fracture, distal radial fracture and hip fractures after surgical fixation, to see the difference of fracture healing time, function recovery and pain sensation after intervention of physical therapy at different time point. from this study, we hope to discriminate the timing of intervention and duration of physical therapy which is the key factors for postoperative prognosis of fractures fixation, and to set up the perfect rehabilitation program in changhua christian hospital. the results of this study will improve the discomfort of fracture patient's recovery or reduce the complications rate, and set up the standard treatment policy of our hospital , also was the model of other hospitals.


Eligibility criteria:
inclusion criteria: * patients with humeral neck fracture, vertebral fracture, distal radial fracture or hip fractures after surgical fixation exclusion criteria: * no
a study to assess the immunogenicity and safety of a trivalent influenza vaccine containing the 2013/2014 formulation of enzira® vaccine in healthy volunteers

Conditions: Influenza, Human

Summary: this is a study to assess the immune (antibody) response and safety of a biocsl split virion, inactivated influenza vaccine containing the 2013/2014 formulation of enzira® vaccine in healthy adult volunteers aged between 18 and 60 years.


Eligibility criteria:
inclusion criteria: * males or females aged between 18 and 60 years at the time of vaccination. * females of child-bearing potential (i.e., ovulating, pre-menopausal, not surgically sterile) must be abstinent or be willing to use a medically accepted contraceptive regimen for the duration of the study. females of child-bearing potential must return a negative urine pregnancy test result prior to vaccination with the vaccine. exclusion criteria: * known hypersensitivity to a previous vaccination with influenza vaccine or allergy to eggs, ovalbumin, chicken protein, neomycin, polymyxin, or any components of the vaccine. * clinical signs of an active infection. * a clinically significant medical condition. * vaccination with a seasonal or experimental influenza virus vaccine in the 6 months preceding study entry. * females who are pregnant or lactating.
weight loss with meal-replacement therapy in teens

Conditions: Obesity, Severe; Pediatric Obesity

Summary: this study seeks to examine whether meal-replacement therapy is able to enhance weight loss among teens with severe obesity. in addition, we are also interested in examining the degree of weight loss needed to improve important cardiometabolic risk factors among adolescents.

this study will involve 130 adolescents (ages 13-17 years old) participating in meal replacement therapy and will last one year (12 months). participants will be asked to strictly follow the individually-prescribed eating regimen, which will include shakes (breakfast and lunch) and pre-packaged frozen entrée meals for dinner, two servings of fruit, and three servings of vegetables per day. daily caloric allotment will be tailored for each individual (number of shakes and frozen meals) by calculating the average daily caloric deficit necessary to achieve negative energy balance (using the metabolic rate/energy expenditure data). shakes/meals will be provided free of charge - fruits/vegetables will be purchased by the participants. guidance will be provided regarding the use of the meal replacement shakes at school, and participants will be encouraged to engage in family meal sessions despite eating different foods. we will measure the changes in resting metabolic rate, traditional clinical risk markers (tg, hdl-c, ldl-c, tc, glucose, insulin), vascular function, weight-related quality of life, and physical activity.

Eligibility criteria:
inclusion criteria: * bmi ≥1.2 times the 95th percentile (based on sex and age) or bmi ≥35 kg/m2 * 13-17 years old exclusion criteria: * type 1 or 2 diabetes mellitus * previous (within 6 months) or current use of meal replacements * previous (within 6 months) or current use of medication(s) prescribed primarily for weight loss (refer to appendix material for comprehensive list) * if currently using weight altering drug(s) for non-obesity indication(s) (refer to appendix material for comprehensive list), any change in drug(s) or dose within the previous 6 months * previous bariatric surgery * if currently using anti-hypertensive medication(s), lipid medication(s), and/or medication(s) to treat insulin resistance (refer to appendix material for comprehensive list), any change in drug(s) or dose within the previous 6 months * if currently using cpap/bipap (for sleep apnea), change in frequency of use or settings within the previous 6 months * history of treatment with growth hormone * neurodevelopmental disorder severe enough to impair ability to comply with study protocol * clinical diagnosis of bipolar illness, schizophrenia, conduct disorder, and/or substance use/abuse * females: currently pregnant or planning to become pregnant * tobacco use * bulimia nervosa * endorsement of vomiting, laxative use, and/or diuretic use for weight control (ede-q) * binge eating disorder * neurological disorder * hypothalamic obesity * obesity associated with genetic disorder (monogenetic obesity) * hyperthyroidism or uncontrolled hypothyroidism * history of cholelithiasis

Keywords: weight loss cardiometabolic meal-replacement therapy
reduction of postoperative wound infections by antiseptica?

Conditions: Surgical Site Infection

Summary: wound infections are a frequent complication in abdominal surgery. the investigators hypothesize that the antiseptic solution 0.04 % polyhexanide (serasept) may reduce occurrence of postoperative wound infections compared to nacl (saline) solution in a prospective randomized setting.

invstigator initiated monocenter randomized controlled trial. intraoperative irrigation of subcutaneous tissue with nacl (saline) solution or antiseptic solution 0.04 % polyhexanide (serasept) in elective abdominal surgery. primary endpoint: ssi 30 days postoperatively according to cdc criteria.

Eligibility criteria:
inclusion criteria: - planned laparotomy for visceral surgery exclusion criteria: * age under 18 years * allergy against polihexanid * laparoscopic surgery * emergency surgery * lack of understanding of the trial
the mannitol-asthma-ciclesonide-study

Conditions: Asthma, Bronchial

Summary: response of a 4 weeks treatment with daily once 320 µg ciclesonide on airway hyperresponsiveness assessed with mannitol. hypothesis: treatment with inhaled ciclesonide reduces airway hyper-responsiveness in 80% of hyper-responsive patients compared to 20% only in the placebo group and the group without airway hyper-responsiveness.


Eligibility criteria:
inclusion criteria: * referred to the pulmonology department of the university hospital basel because of suspected asthma defined as respiratory symptoms like wheezing or cough or chest tightness. * asthma symptoms partly controlled according to gina (global initiative for asthma, october 2006) 1 week prior to randomization * fev1 ≥ 70% predicted exclusion criteria: * smoker and ex-smoker with \>10 pack years * copd (chronic obstructive pulmonary disease) * upper respiratory tract infection within the past 4 weeks. * ics or oral steroids during the previous month before inclusion * beta-blockers within the past 4 weeks * current treatment with medication as defined in section concomitant medication (ics other than study medication, ß-blockers) * pregnancy * known malignancy

Keywords: asthma
effectiveness of ultrapulse for the treatment of androgenic alopecia among malaysian: a quasi-experimental study

Conditions: Androgenic Alopecia; Alopecia

Summary: the goal of this study is to to evaluate the effectiveness of ultrapulse for the treatment of androgenic alopecia among malaysian. the main questions it aims to answer are: * the efficacy of ultrapulse in treatment of androgenic alopecia among malaysian * the safety and adverse effect of ultrapulse treatment. * the quality of life of androgenic alopecia among malaysian.

ultrapulse is a is a laser beauty device using erbium-doped yttrium aluminium garnet laser (er:yag). er:yag laser is a laser with wavelength of 2940nm which is able to penetrate into the dermis to a depth of 3-4 mm, and energy absorption occurs in the area of the dermal papilla, resulting in an increase in blood circulation of the papilla and activation of metabolism in the hair follicle. it generates multiple micro pores at the epidermal layer that enhances the absorption of the active substances that help to stimulate hair growth developed by lyzer co. ltd in korea.

Eligibility criteria:
inclusion criteria: - patient with androgenic alopecia with severity of norwood-hamilton scale ii to vi for male and ludwig scale i to iii for female exclusion criteria: * use of topical or systemic medications affecting hair growth within the 6 months before recruitment * previous hair transplantation, underwent scalp reconstruction procedure, hair braiding or scalp tattoo

Keywords: androgenic alopecia alopecia treatment ultrapulse malaysian
impact of uterine closure techniques on the cesarean scar thickness after repeated cesarean section

Conditions: Cesarean Section, Repeated; Cesarean, Uterine Scar Thickness; Cesarean, Residual Myometrial Thickness; Cesarean Section Complications; Cesarean Section; Complications, Wound, Dehiscence

Summary: we compares two techniques of uterine closure on myometrium thickness at the site of uterine scar of women who underwent repeated cesarean section. we will evaluate myometrial thickness by transvaginal ultrasound six months after cesarean.


Eligibility criteria:
inclusion criteria: * previous two or three cesarean * gestational weeks \>=36 weeks exclusion criteria: * risk of obstetric haemorrhage * suspicion or diagnosis placenta previa or accrete syndrome * chorioamnionitis * uterine myoma in the anterior uterine segment * hysterotomy other than lower segment uterine incision at previous cesarean